Showing papers in "Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery in 1969"
TL;DR: An investigation of factors controlling healing and long term stability of intra-osseous titanium implants to restore masticatory function in dogs revealed that an integrity of the good anchorage of the implant requires non-traumatic surgical preparation of soft and hard tissues and a mechanically and chemically clean implant.
Abstract: An investigation of factors controlling healing and long term stability of intra-osseous titanium implants to restore masticatory function in dogs revealed that an integrity of the good anchorage of the implant requires: (1) Non-traumatic surgical preparation of soft and hard tissues and a mechanically and chemically clean implant. (2) Primary closure of the mucoperiosteal flap, to isolate the implant site from the oral cavity until a biological barrier has been reestablished. (3) Oral hygiene to prevent gingival inflammation. Provided these precautions are taken, it is possible to subject dental prostheses, connected to the implants, to unlimited masticatory load. With these precautions such implants were found to tolerate ordinary use in dogs for periods of more than 5 years without signs of tissue injury or other indications of rejection phenomena.Macroscopic clinical investigation, stereomicroscopy, roentgenography and light microscopy of the implant site in situ and after removal from the body showed...
1,765 citations
TL;DR: Procedures extensively based on new principles for the surgical management of these malformations are described and shown in detail, allowing consideration of the entire reconstructive task in the primary operation.
Abstract: The congenital cleft lip deformity is defined as a tripartite reconstructive problem: restoration of the cleft maxilla, correction of the nasal deformity, and repair of the lip. Procedures extensively based on new principles for the surgical management of these malformations are described and shown in detail. They allow consideration of the entire reconstructive task in the primary operation.For maxillary reconstruction the osteogenic capacity of tissues bordering the cleft is utilized. The operation involves subperiosteal exposure of the bone and the establishment of periosteal continuity between the maxillary segments, using local flaps of the periosteal membranes. Surgicel® is used as a scaffolding between the periosteal surfaces to bring about deposition of a mass of bone. In complete clefts a two-stage procedure is recommended for periosteal repair and for the implantation of Surgicel. Observations on the effect of periosteo-plasty confirmed previous reports: the procedure will lead to the formation ...
68 citations
TL;DR: In a full-thickness scrotal autograft transplanted to a rabbit's ear inside a transparent ear chamber, the following events were observed through a high resolution vital microscope.
Abstract: In a full-thickness scrotal autograft transplanted to a rabbit's ear inside a transparent ear chamber, the following events were observed through a high resolution vital microscope: 1. To and fro circulation of plasma and red blood cells around the graft and sometimes of donor area blood contained within the preexisting vessels of the graft begins immediately after the graft is laid in place. 2. Slow irregular circulation of blood from the recipient bed begins in the graft, 24 to 48 hours after grafting. 3. Circulation first develops inside the preexisting vessels of the graft. 4. Moderate vascular proliferation starts shortly after circulation begins. In this study, it appeared to originate from preexisting graft vessels. 5. Modification of the preexisting vascular pattern of the graft takes place after circulation begins. It is presumably due to the new blood flow characteristics which depend largely on the circulation in the recipient bed and on the recipient bed to graft connections. 6. Graft epiderma...
55 citations
TL;DR: A classical, rectangular sliding flap with compensatory triangles excised on both sides of the base was used for the reconstruction of nasal midline skin defects from the root to the tip in 15 cases.
Abstract: A classical, rectangular sliding flap with compensatory triangles excised on both sides of the base was used for the reconstruction of nasal midline skin defects from the root to the tip in 15 cases. The method is simple and reliable and the cosmetic result has been good in all the cases.
53 citations
TL;DR: In contact microangiograms of full-thickness scrotal autografts transplanted to the ears of rabbits, the following events were noted: the first vascular filling within the graft was noted and new vessels in the superficial layers of the graft appeared to arise from preexisting graft vessels.
Abstract: In contact microangiograms of full-thickness scrotal autografts transplanted to the ears of rabbits, the following events were noted: 1. The first vascular filling within the graft was noted between 24 and 48 hours after grafting. It was characterized by poor vascular filling with contrast medium which suggested irregular blood circulation and perhaps a low perfusion pressure. 2. The first vascular connections between recipient bed and graft were few. They were between the recipient bed and the mouths of large dilated vessels in the graft. 3. Invasion of the lower layers of the graft by capillaries from the recipient bed was noted between 48 and 72 hours after grafting. This invasion did not seem to be responsible for the increased number of small vessels in the superficial layers of the graft. New vessels in the superficial layers of the graft appeared to arise from preexisting graft vessels. 4. Vascular dilatation in the recipient bed and graft were marked until about the second or third day after graft...
41 citations
TL;DR: It was shown that the psychological factors dominate in the subjects although it is of a more serious nature for only one subject in two, and Jaw malformation appears to be hereditary since several respondents have reported relatives with similar malformation.
Abstract: Ninety-five patients suffering from malformation of the jaws have been studied with respect to their biological and psychological complaints. The subjects have completed a questionnaire with fixed response alternatives prior to treatment. It was shown that the psychological factors dominate in the subjects although it is of a more serious nature for only one subject in two. Thirty per cent of the subjects state that they suffer from gastric and intestinal disorders. Seventy per cent justify their wish for treatment by referring to deficient chewing and speech functioning. Jaw malformation appears to be hereditary since several respondents have reported relatives with similar malformation. The subject material is being followed up and a report of reactions after treatment will be made subsequently.
32 citations
TL;DR: Out of 21 wrist joints that were followed up, 9 became symptom-free, 9 were substantially improved, whereas 3 showed no improvement, all the patients who were gainfully employed were able to resume their former occupation.
Abstract: In distal fracture of the radius or distorsion of the wrist, the radio-ulnar joint is often injured, this is manifested as persistent pain on movement, impaired mobility, and weakness in the wrist Resection of the head of the ulna is a simple operation, which, as a rule, improves the function of the wrist Out of 21 wrist joints that were followed up, 9 became symptom-free, 9 were substantially improved, whereas 3 showed no improvement All the patients who were gainfully employed were able to resume their former occupation
25 citations
TL;DR: In the Orthopaedic Hospital, Copenhagen, 26 patients, 16 with radial paralysis and 10 with sequelae of softtissue injuries to the dorsum of the hand or to the forearm, were operated upon during the period 1954-1965.
Abstract: Operative methods for activating wrist extension, thumb abduction, and finger extension in the event of defects in these functions are birefly reviewed.In the Orthopaedic Hospital, Copenhagen, 26 patients, 16 with radial paralysis and 10 with sequelae of softtissue injuries to the dorsum of the hand or to the forearm, were operated upon during the period 1954-1965.Finger extension was activated in 11 cases by flexor digitorum sublimis by the method of Boyes and in 15 cases by flexor carpi ulnaris. The wrist was activated in 13 cases by pronator teres. The abductor pollicis longus was activated by flexor carpi radialis or by palmaris longus. The results were assessed by the criteria of Zachary and compared with his results as well as those of Moberg & Nachemson which were somewhat better than ours, especially in the group having sequelae of soft-tissue injuries. The difference is presumably due to the operative technique, and in the future we intend to resect the dorsal carpal ligament as well as the end o...
23 citations
TL;DR: The most important factor responsible for the observed prognostic improvement seems to be the possibility of reducing the heat loss and of diminishing would infection.
Abstract: In a series of 30 severely burned patients treated with warm dry air the calculated mortality was 19.4 cases. Only 5 of the very severely burned patients died.The most important factor responsible for the observed prognostic improvement seems to be the possibility of reducing the heat loss and of diminishing would infection. The basal metabolic rate could be significantly reduced in the burns cases treated with warm dry air as compared with similar cases treated at normal room temperature.During the first 3 weeks of the course of the burn there was a significant correlation between the rate of evaporative loss of water and the extent of burn as well as between changes in the BMR and the extent of burn. Except on the first 2 days, a significant correlation was noted between the changes in the basal metabolic rate and the rate of evaporative loss of water.The patients' metabolic rate increased greatly after surgical cleaning of the wound and removal of skin for grafting. After the graft had been applied, th...
21 citations
TL;DR: Since 1961, twenty-three women with major arm swelling following treatment of cancer of the breast by radical mastectomy, radiotherapy, or a combination of both, have been treated by the buried dermis flap operation.
Abstract: Since 1961, twenty-three women with major arm swelling following treatment of cancer of the breast by radical mastectomy, radiotherapy, or a combination of both, have been treated by the buried dermis flap operation.Reasons for regarding the arm swelling as due to lymphatic rather than venous obstruction are discussed.Operations used in the past in the surgical treatment of the post-mastectomy swollen arm are enumerated and discussed.The buried dermis flap operation when used in the treatment of the post-mastectomy swollen arm, can be expected to provide 60% of Good results, and Satisfactory improvement in 35%. Recurrent attacks of cellulities in the limb are abolished in 80% of cases, and greatly improved in the remainder.
15 citations
TL;DR: A short report is given of a clinical material of 11 male and 3 female transsexual patients operated on in Copenhagen since the well known Christine Jorgensen case in 1952, where actual cure of transsexualism is probably impossible.
Abstract: A short report is given of a clinical material of 11 male and 3 female transsexual patients operated on in Copenhagen since the well known Christine Jorgensen case in 1952. A more detailed analysis of the 14 cases, includig psychiatric evaluation, will be published elsewhere. Actual cure of transsexualism is probably impossible. As a symptomatic treatment, however, the socalled conversion operation in males and mastectomy in females seems to be great help to a selected group of these patients. The surgical procedures should be carried out in conjunction with hormone therapy and under psychiatric supervision, as a result of a team-work of specialists.
TL;DR: A full-thickness scrotal skin autograft transplanted to an ear of a rabbit shows the following heat emission changes when studied with infrared thermography under the conditions of this experiment.
Abstract: A full-thickness scrotal skin autograft transplanted to an ear of a rabbit shows the following heat emission changes when studied with infrared thermography under the conditions of this experiment:1. Normal heat emission from recipient bed vessels under the graft is present immediately after grafting, but is soon masked by graft edema. The normal pattern of heat emissions from the recipient bed is restored by the sixth to eighth day after grafting when edema has disappeared.2. Recipient bed vasodilatation and proliferation slightly increases the heat emission from the graft area if this area is not masked by graft edema.3. Areas with or without a fibrinous scab, but uncovered by epithelium are registered thermographically as slightly colder than the surrounding normal skin. This appears to be the result of evaporation from their surfaces.
TL;DR: A terracotta head which exhibited a complete unilateral cleft lip as well as the characteristic nasal deformity connected with this congenital malformation and can be dated about the middle of the 4th century B.C.
Abstract: In the archeological museum at Corinth I had the good fortune to be able to examine a terracotta head, which exhibited a complete unilateral cleft lip as well as the characteristic nasal deformity connected with this congenital malformation. The head represents a comic actor and can be dated about the middle of the 4th century B.C. The accuracy with which the unknown Peloponnesian sculptor has reproduced the complexity of the deformity makes this find unique.
TL;DR: The author submits a material of 520 operated cases of Dupuytren's contracture from the Department of Hand Surgery, Orthopaedic Hospital, Copenhagen, and it is concluded that the future operative method should be limited fasciectomy.
Abstract: The author submits a material of 520 operated cases of Dupuytren's contracture from the Department of Hand Surgery, Orthopaedic Hospital, Copenhagen, followed for 2-8 years. On the basis of the 183 oldest cases, 70 having total and 113 limited fasciectomy, it is concluded that the future operative method should be limited fasciectomy. 450 cases treated by limited fasciectomy were included in the follow-up study. These cases were analysed according to which surgeon had performed the operation. The technique had differed somewhat, and from the material it is apparent that the operation ought to be a balance between local radicality and gentle treatment of the tissues to avoid local recurrence on the one hand and cicatricial contractions and posttraumatic fibrosis and dystrophy on the other. In the most severe cases plastic repair of the skin or a McCash procedure should be applied.
TL;DR: The immunoglobulins decreased from initially normal levels and reached the lowest values on days 4 and 7, IgG decreasing to 40-70% of established normal values for healthy controls and IgM and IgA levels was less pronounced.
Abstract: Twelve out of 30 burned patients treated with warm dry air were investigated for the amounts of circulating IgG, IgM, IgA, and α2 macroglobulin and with respect to the bacterial flora.The immunoglobulins decreased from initially normal levels and reached the lowest values on days 4 and 7, IgG decreasing to 40-70% of established normal values for healthy controls. The fall of the IgM and IgA levels was less pronounced. The decrease in immunoglobulin concentration correlated roughly with the extent of burning. All the immunoglobulins increased subsequently in the course and reached maximum values after 10 days for IgM, after about 2 weeks for IgA, and after 3 weeks for IgG.Two patients with large burns died, one after 8 days in circulatory failure and the other on day 32 of septicaemia due to Ps. aeruginosa. In the latter the immunoglobulin pattern differed markedly from those of the others, in that it showed a successive decrease in concentrations to about 50% of normal values.A detailed analysis of the ba...
TL;DR: Bromelain (Ananase®G)—a group of proteolytic enzymes which are said to have effect on oedema and hematomas in soft tissue injuries—has been tested in a double blind series of 98 patients undergoing plastic surgery and could not find any effect at all.
Abstract: Bromelain (Ananase®G)—a group of proteolytic enzymes which are said to have effect on oedema and hematomas in soft tissue injuries—has been tested in a double blind series of 98 patients undergoing plastic surgery. The authors could not find any effect at all of bromelain. This preparation was not introduced in Sweden partly due to the results of this investigation.
TL;DR: The authors demonstrated in experimental pedicle skin flaps in rats, that halothane may cause larger necrotic changes than expected, especially if the flap is of unfavourable size and “critical” and subjected to bleeding.
Abstract: Anesthetics like ether, halothane and methoxyflurane may cause side effects on the circulation of pedicle skin flaps. In patients operated under halothane anesthesia the circulatio of pedicle skin flaps was observed to be exceptionally often disturbed. The authors demonstrated in experimental pedicle skin flaps in rats, that halothane may cause larger necrotic changes than expected, especially if the flap is of unfavourable size and “critical” and subjected to bleeding.
TL;DR: Oxygen consumption was measured by Warburg technique in burned and unburned skin at intervals of one hour, one week and two weeks post-burn in a small number of animals and was higher in the deep parts of skin.
Abstract: Burns of approximately 15% of body area were inflicted on three series of white male rats Time-temperature combinations were employed which produced leasions resembling a superficial second degree, a deep second degree and a third degree burn respectivelyOxygen consumption was measured by Warburg technique in burned and unburned skin at intervals of one hour, one week and two weeks post-burnIn a small number of animals oxygen consumption was studied in superficial parts of skin In most animals deep parts (including some dermal tissue and panniculus carnousus) were examined by the same technique Oxygen consumption was higher in the deep parts of skinIn the deep parts oxygen consumption one hour postburn was depressed sharply in the deep second degree burn (90°C for 5 sec) and zero in the third degree (90°C for 20 sec) However, it was increased in the superficial second (70°C for 5 sec) This may be due to qualitative changes caused by increased vascularity or to changes in the tissue mediated by pro
TL;DR: It was confirmed, that the disease process was confined to the midface, but no signs of it were found in any other organs, and the histology were similar to what has previously been discribed in cases like this one.
Abstract: The noticable features of this case of midline granuloma of the face are: That the ulceration of the nose started as a result of trauma. The external location made it possible to observe the ulcer and also to observe the fate of the skin grafts applied to it. The behaviour of these grafts were strikingly simulare to that of homografts e.g.—take in the beginning and later rejection. This and the seemingly retarding effect of cortison on the course of the disease, tend to support the theory that the disease is an auto-immune disease. No immunological studies were done, but would be indicated in similar cases.The patient was under observation from the beginning (April, 1958) to the end (October, 1963). At autopsy it was confirmed, that the disease process was confined to the midface, but no signs of it were found in any other organs.The histology were similar to what has previously been discribed in cases like this one.